international conference on spice prevention issues 2004, a ‘herbal incense’ product sold under

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  • International Conference on SPICE Prevention Issues

    Conference Handout

    First International Conference on Toxicity, Risk Profiles, Legal Control and Prevalence of Synthetic Cannabinoids

    25-26 September 2012, Frankfurt am Main

  • Conference Handout Conference on SPICE Prevention Issues 2012 3

    Introduction

    Welcome to the Conference on SPICE Prevention Issues 2012. We are delighted to share the results

    of the research on toxicity and prevalence of synthetic cannabinoids collected in the context of the

    EU-project SPICE and synthetic cannabinoids, which is funded by the European Commission, the

    Federal Ministry of Health and the City of Frankfurt. The conference gives the opportunity to learn

    more about the phenomenon of Spice Products and to discuss prevention approaches applicable to

    new psychoactive substances.

    Around 2004, a herbal incense product sold under the brand name Spice appeared in Europe.

    Herbal incense or herbal smoking mixtures were gaining a high degree of popularity by mid-2008. In

    December 2008, German labs identified synthetic cannabinoids in these products. Synthetic

    cannabinoids (or, more precisely, cannabinomimetics) are psychoactive substances that mimic the

    effects of 9-tetrahydrocannabinol (THC), the main active compound in cannabis / marijuana. They

    bind to the same cannabinoid receptors in the brain as THC. However, many of the synthetic

    cannabinoids are much more potent than THC.

    Usually the synthetic cannabinoids are sprayed on the plant material. The herbal mixtures are sold in

    small bags with a brand name on it, often labelled not for human consumption. The active

    compounds are not declared as ingredients on the packaging. Since Spice products are mostly sold

    and discussed on the Internet, they are often regarded as largely an Internet phenomenon

    (EMCDDA 2009) and therefore (m)onitoring the Internet is becoming essential to identify and

    understanding new trends (Deluca 2012).

    Most of the respective cannabinoids were first synthesised in the context of pharmaceutical research

    projects carried out in the 80s and 90s. They had never shown up in any commercially available

    product before and no human studies with these cannabinoids have been carried out (EMCDDA

    2009). The JWH series, created by the chemist John W. Huffmann at Clemson University, is the most

    common family of synthetic cannabinoids (e.g., JWH-018, JWH-073, and JWH-210). Other names of

    cannabinomimetics include HU-210, AM-694 or CP 47,497. There are hundreds of synthetic

    cannabinoids that may function as active compounds of herbal mixtures (Rosenbaum et al. 2012).

    The constant change substances used by manufacturers and traders makes it difficult to assess,

    monitor and control the supply of these products. Furthermore, prevention and treatment agencies

    face new problems associated with the use of herbal mixtures and other legal high products (see,

    e.g., NACD 2011).

    There is a strong need of organisations active in prevention work for scientific facts and arguments

    when discussing the risks associated with the use of new psychoactive substances with drug users.

    For health care providers it is important to be familiar with symptoms of intoxication and other side-

    effects. Therefore it is necessary to supply substantial science-based information on toxicity and risk

    profiles.

    So far, there have been few reports on clinical effects in humans of herbal mixtures or synthetic

    cannabinoids (Forrester et al. 2012). The knowledge on the toxicity of these substances is limited, but

    indeed there are some reasons for concerns that these drugs may have a greater potential to cause

    harm (EMCDDA 2009). These assumptions largely derive from the fact that many

    cannabinomimetics work as full agonists to the human cannabinoid receptors, while THC shows only

    partial agonist affinity. There are speculations that some synthetic cannabinoids may have a

    carcinogenic potential. Furthermore, some of these substances might have a relatively high potential

    to cause dependence and intoxications because of the unknown ingredients as well as the varying

    amounts and potencies of added drugs.

  • Conference Handout Conference on SPICE Prevention Issues 2012 4

    International Conference on SPICE prevention issues

    Programme

    Tuesday 25 September

    12:30 Registration

    Chair: Albert Kern, Federal Ministry of Health, Germany

    13:15 Welcome and opening remarks

    PD Dr. Volker Auwrter (University Medical Center Freiburg)

    Ms. Judith Bugreev (Office of the Drug Commissioner of the Federal Government)

    Ms. Rosemarie Heilig (Councillor for Environment and Health, City of Frankfurt)

    Michael Evans-Brown (EMCDDA)

    Presentation of the results of the SPICE project

    Plenary session

    14:00 PD Dr. Volker Auwrter, University Medical Center Freiburg

    Analytical and clinical experiences - from product monitoring to drug testing

    14:15 Prof. Dr. Siegfried Knasmller, Medical University Vienna

    Assessment of toxicological properties and establishment of risk profiles

    Dr. Verena Koller, Medical University Vienna

    Genotoxic properties of selected spice compounds

    14:30 Prof. Dr. Ilkka Ojanper, University of Helsinki

    Detection of synthetic cannabinoids in human specimens

    Teemu Gunnar, National Institute for Health and Welfare, Helsinki

    Prevalence of SPICE products in Finland

    14:45 Prof. Dr. Bela Szabo, Albert-Ludwigs-University Freiburg

    Effects of synthetic cannabinoids, identified in smoking herbal products, on synaptic transmission

    in the brain

    15:00 Dr. Werner Bernhard /Prof. Dr. Wolfgang Weinmann, University of Bern

    Measures in Switzerland in the fight against new drugs such as SPICE products and bath salts

    15:15 Discussion

    15:30-16:00 Break

    16:00 Michael Ptz, Federal Criminal Police Office, Germany

    Legal Highs in the legal system

    16:15 Dr. Bernd Werse, Centre for Drug Research, University of Frankfurt

    Social research on synthetic cannabinoids: A synopsis of the available data

    16:30 Michal Kidawa, National Bureau for Drug Prevention, Poland

    Legal Highs in Poland

    16:45 Discussion

    17:00 Concluding remarks

  • Conference Handout Conference on SPICE Prevention Issues 2012 5

    International Conference on SPICE prevention issues

    Programme

    Wednesday 26 September

    Chair: Albert Kern, Federal Ministry of Health, Germany

    Legal Highs: New challenge for traditional prevention approaches?!

    Plenary session

    9:15 Stefanie Helmer, Institute for Epidemiology and Prevention Research GmbH (BIPS), Bremen

    Findings of a German subsample of a European social norms intervention study.

    9:30 Renate Lind-Krmer, Drug Coordination Department of the City of Frankfurt am Main /

    Karsten Tgel-Lins , basis e.V.

    Keynote speech on prevention advice

    10:00 Alexander Bcheli, City of Zurich, Departement of Social Affairs, Addiction and Drugs,

    Streetwork Youth Advisory Service

    Keynote speech on prevention advice

    10:15-10:30 Break

    Panel discussion

    10:30 Renate Lind-Krmer, Drug Coordination Department, City of Frankfurt, Germany

    Alexander Bcheli, City of Zurich, Departement of Social Affairs, Addiction and Drugs,

    Streetwork Youth Advisory Service

    John Arthur, Crew 2000, Edinburgh, UK

    Mireia Ventura, Energy Control, Spain

    Michaela Goecke, Bundeszentrale fr gesundheitliche Aufklrung (Federal Centre for Health

    Education), Germany

    12:00 Concluding remarks

    http://www.uniklinik-freiburg.de/rechtsmedizin/live/SpiceConference.html

  • Conference Handout Conference on SPICE Prevention Issues 2012 6

    Analytical and clinical experiences from product monitoring to drug testing

    V. Auwrter, M. Hutter, S. Kneisel

    Institute of Forensic Medicine, Forensic Toxicology, University Medical Center Freiburg, Germany

    Products containing synthetic cannabinoids have become a challenge for many professions, among

    them medical staff and chemists, but also staff working in the area of drugs prevention or drugs

    counselling.

    In the frame of the SPICE project we conducted a continuous product monitoring providing

    information on the substances used as active ingredients for these products. Since 2008 more than

    40 different compounds appeared in herbal mixtures and the product composition was constantly

    changing in terms of type and amount of added drugs. In Germany we observed a quick reaction of

    the producers to legislative measures in the first years. Interestingly, the shift to new substances was

    observed even before new regulations came into force. Further observations were a trend to the use

    of high affinity cannabinoid receptor agonists and the appearance of rather exotic modifications,

    many of them not described in the scientific literature before. Recently, producers seem to partially

    revert to already legally controlled substances like JWH-018.

    The continuous monitoring of the Spice product market enabled us to develop up-to-date methods

    for the detection of synthetic cannabinoids in blood, urine, oral fluid and hair. These methods help to

    mitigate one of the major motivations for the use of these drugs the lacking detectability by

    commonly used drug test systems. However, these meth

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